Sunday, January 4, 2009

Violet's Birth Story

Disclaimer: Well, telling how someone was born with any level of candid detail is unavoidably TMI, I think, so consider yourself forewarned.

At my 38-week visit to the midwife, we were talking about plans for help at home after the baby was born and when I half-jokingly bemoaned the lack of help I would have if I didn't have the baby until after Christmas (because of Rob's schedule at the hospital, etc), she not-jokingly-at-all suggested that we schedule an induction for right before Christmas, a few days before my due date. I was scheduled on December 22 at 10am for something that was not technically an induction but rather "cervical ripening" where they would put prostaglandin gel on my cervix to get it ready to dilate and efface. I felt a bit conflicted about not waiting for my body to go into labor on its own but this option seemed like a low-key intervention unlikely to spiral into other interventions I didn't want, so we decided to give it a try.

In the early morning hours of December 22, I started to have contractions that were painful enough to wake me up but were still 7, 8, or 9 minutes apart. As the morning got going, the contractions sometimes spaced out a bit more but I never went longer than 15 minutes without one. In hindsight, I think I was in early labor at that point. We talked to my midwife on the phone and decided to go in anyway for the prostaglandin as planned; if I was in the early stages of labor, the drug should be just that much more likely to work and if not, my reasons for trying to jumpstart labor still stood.

Rob and I arrived at L&D with our bags and chipper smiles and all at 10am sharp; it felt kind of strange to be arriving with my packed bag when being sent home if the prostaglandin didn't do anything was such a real possibility. I was put in the L&D triage area, changed into a gown, got monitored for a while to see how the baby was doing, and then at 11am my midwife arrived to do the deed. The Friday before (this was a Monday) I had been dilated 1 cm when checked at the office, and she said that now I was 2 cm and put the prostaglandin gel in my dilating cervix, using double the dose the nurse originally brought out. Yikes! Within 15 minutes, my contractions had really intensified and eventually were coming every 3-4 minutes. After sitting in bed on the monitors for an hour, they let me get up and walk around so Rob and I circled the hallways, our slow walk punctuated by ever-intensifying contractions that I couldn't walk or talk or stand upright for.

The deal that you apparently strike with this hospital when going in for this kind of cervical ripening is that they will give you 2 hours from when the drug is placed to show some cervical change. If there is no change, then you get sent home; if there is, you get sent from the triage area over to "real" L&D. By the time my 2 hours were up, my contractions were every 2 minutes apart and intense and I was having quite a bit of gastrointestinal upset. Thankfully, when my midwife came back and checked me at 1pm, I had also progressed to 3 cm so we were bundled off across the hallway into L&D where we had our own room (with my own bathroom, which was becoming important to me, given the GI upset). My memories of the next period are somewhat hazy-- I know we played Bach on the CD player in the room, I know I changed positions about every 2 contractions, I know that I was in a fog of pain only penetrated by Rob comforting me and helping me cope. I sat on the birthing ball, I labored on all fours, I stood and leaned on Robert, I tried lying on my side. My contractions were 60 to 90 seconds apart by this time and I felt like there was barely time to rest before the next one came.

A little after 3pm, I started feeling nauseous. I didn't have an IV so I had been drinking a lot of juice all morning to stay hydrated, and all of the sudden ALL the juice started coming back up. I was sitting on the birthing ball at the time and as I threw up, my membranes ruptured. My first thought was actually, "Oh great-- not only am I throwing up everywhere, now I am peeing all over myself too!" It turns out that no, it was my waters breaking, although that isn't any less gross, really, is it? Anyway, I started feeling kind of crazy at that point and out of control (yes, those of you following along at home are right if you have guessed that I was in transition), asked for the nurse, and when she was in the room, I started to feel like I had to push. Apparently, those are magical words in an L&D room because there was a mad scuttle of activity when I said them. The nurse checked me and I was practically complete, they paged my midwives, they started rearranging the bed and furniture in the room, and various people started coming in and getting dressed in baby-catching gear and whatnot. I was just overwhelmed with the need to push but everyone from Rob to the nurses kept saying, "NO! Pant! Blow!" It was TERRIBLE not to push and I was crying; each contraction I had during these (very brief) minutes) was really dreadful as I saw my belly solidify into this rock-hard, perfectly-round shape as my body tried to get the baby out on its own. (Well, that's what it felt like, anyway...) There was some trouble finding either of my midwives so an OB/GYN resident came in and started getting ready to deliver the baby, but then one of my midwives finally made it and I FINALLY was allowed to start pushing. This whole sequence from feeling nauseous to finally starting pushing felt very eventful but it all happened in, oh, less than 10 minutes or so.

I pushed less than 10 times (Rob claims it was more like 5) and Violet was born at 3:33pm; this was the screaming part of labor. I am not normally a screaming, raise-your-voice type of person but the situation seemed to call for it, so there you go. I was hoarse for almost 2 days afterwards. Violet turned a little blue during and right after being pushed out (which you can totally see in her video) but got to a nice healthy pink color pretty quickly. It HURT to push her out, of course, but it was amazing how the pain subsided immediately after she came out. The cord came out and the nurses and my midwife all commented on how long it was. I thought, "Um-- yay me?" Then the placenta, which hurt more than I thought it would, just like with Grace. (And do you know that you have to push the placenta out, sort of like pushing the baby?) And all of this was happening concurrently with Violet having her first cry, the cord being cut, being taken over to the other side of the room to get rubbed down and weighed and gunk put into her eyes and whatnot. I did tear during pushing, in the same place where I had an episiotomy with Grace, so the next thing that happened was my midwife repairing the tear. By this time, I was coming down off the endorphin/adrenaline/who-knows-what high and I was all jittery and trembly and jumpy at every touch; my poor midwife had to give me two shots of Lidocaine to repair my tear without me jumping off the bed. It was sometime during the repair that Rob brought Violet back over to me and I immediately felt calmer and less jittery. I got to hold her pretty much the whole rest of the time we were down in L&D; we stayed there about an hour, mostly without a lot of other people around, before being pushed up to our postpartum room. It was during that hour or so that the whole ocean of motherhood and love and devotion washed over me and I started to realize that I have another person who will call me "Mama", another human being linked to me forever, another little girl to carry and raise and love.

So that was that! It was just 4.5 hours from when the prostaglandin gel went in to when Violet was born, which still stuns me a little. And hey-- I had a baby without an IV or an epidural or pain medication! (Unless you want to count the Lidocaine for the tear repair at the end...) I certainly don't think it is a morally better choice or anything but part of me feels, "Wow. I did it." I don't think I could have coped with much more labor of that intensity, though. When I was in the puking phase, I was thinking in my head that when the nurse came in and checked me, if she told me I was still only 5 cm or something, I was going to weep and then go for the epidural. Of course, I was in transition at the time, the famous hallmark of which is feeling like you can't go on and are going to give up, so maybe everyone feels like that during transition. Anyway, it was just the right balance of short and intense for me to be able to cope with. All in all, it was a really different experience than Grace's birth. Kind of shockingly different, actually.

I'm glad I didn't get an epidural, because it was so nice to be able to change positions during labor and use lots of different coping mechanisms. And not have an IV (which I hate with the fire of a thousand suns). And not have a catheter (which meant that the peeing situation was much less crazy postpartum). And after the birth be able to get up and do whatever I wanted whenever I wanted. It's kind of funny, because after Grace's birth I was glad I DID get the epidural, and I still think I would in the same situation (slow long labor on pitocin, stuck in the bed hooked up to lots of monitors). I'm obviously not a die-hard natural childbirth spokeswoman or anything, but I do think it is all-in-all a more comfortable and pleasant option if the situation allows you to cope in other ways.

This labor was so short that we felt a little abandoned by the nurses and midwives and whatnot during the most difficult part of the labor. I think a nurse must have come in to monitor the baby for a few minutes at least once while I was in L&D, but I have no memory of it. I don't blame them; I had just taken 2 hours to go from 2 cm to 3 cm, so how was anyone going to predict that it would be just another 2 hours to go from 3 cm to 10 cm? I think my midwives were annoyed that the nurses didn't page them earlier (to tell them I was in active labor) because they plan on one of them being there to help coach.

Speaking of coaching, Rob had a much more active role this time around and did such a good job supporting me and helping me cope and believing in me and generally being present and involved and whatnot. There was no one else in the room so he was it as far as support for me, but he did a really fantastic job. I did the whole stereotypical thing where I snapped at him for touching me wrong or too hard or whatever there at the end, but he was wonderful throughout it all.

I really liked how our hospital set up the postpartum time-- all the immediate procedures on the baby are done in your L&D room, a relaxed time in your L&D room without a lot of other people around, and then the postpartum floor was all shiny and new and freshly remodeled. Does that make me shallow?

I do wonder when I would have gone into labor if I had turned down the prostaglandin, or if things would have been easier if we'd gone with the lower dose, but overall I am very happy with how things went and the decisions we made. It has been really wonderful to have 2 full weeks with Robert at home, definitely worth whatever risks there were in trying to cheat Mother Nature a little. All's well that ends well, and this definitely ended well:

Yay! I love reading your birth stories. I actually felt my whole body tense through the part where you described wanting to push...this was BY FAR the worst part for me, and Jack dropped onto my cervix at around 8-9 centimeters, so I felt that way for over an hour. You put it into words better than I ever could!

I teared up at the end when you talked about holding her and your hour postpartum. Truly beautiful.

Awesome job Julia. So glad it was a better birth this time :) So much like how I felt during mine too with the being so much freer without the catherter and epidural and such, and the feeling like you can go on during transition. And it sels SO much better after not having had the drugs and stuff. BTW, saw your post on the breast pads. I am a major leaker with this oversupply problem, and I really recommend the hemp/fleece pads that you can wash. I bought a whole bunch in ebay used, and a few new. I got some bravado coolmax ones at the well center and they SUCK!